Who is John Galt?

whip-counting democrats

Jay Cost (H/T to BigGovernment.com): Factors in the search for House Democrats to approve the Senate healthcare bill.

How many such "options" does Nancy Pelosi have among these 38 nay voters? That's the big question, and it is impossible to pin down a precise answer. However, it's important to note that the Stupak amendment is precisely the kind of bill that the party leadership does not allow onto the floor - it passed, but with a majority of the majority voting against it. That Pelosi allowed this to happen suggests that she needed the Stupak voters, which in turn suggests that they are (or at least, were) more numerous than however many pocket votes she had.

Cost also mentions here (and elsewhere) that reconciliation will be about winning over liberal Democrats rather than moderates.  Consider the tax on "Cadillac" plans, which is part of the Senate bill.  House liberals sensitive to union interests are going to want that fixed in the reconciliation bill before they'll okay the Senate healthcare language.

on reconciliation

Following Obama's speech on Wednesday, I was disappointed at some of the misunderstanding that's out there, about the Democrats' "reconciliation strategy."  Even Limbaugh got it wrong initially, though he corrected himself on Thursday.

What you need to realize is that the House and Senate have to pass the same, identical text.  Ordinarily, their separate bills get sent off to a joint conference that merges them, and then both chambers vote on the product of that conference.  Top Dems were in the middle of merging the House and Senate bills when Scott Brown was elected.  Brown effectively killed that process, because the merged bill is subject to a filibuster in the Senate.  It would have never reached cloture.

The two chambers passed significantly different bills.  The House legislation included a "public option," while the Senate relied on a mandate.  The bills differed in taxation, the "exchanges" worked differently, and they took different approaches to Medicare.  The two versions are each as liberal as their respective chamber can tolerate, which is why they both passed on very close, party-line votes.  And even before Brown was elected, Democrats were having problems reaching agreement on the final merged product.

"Reconciliation" refers to a rule for passing budget items with limited debate.  Since the filibuster is technically an unending debate, putting a time limit on debate defeats the filibuster.  Reconciliation measures are required to get an up-or-down vote in the Senate, where it takes 51 votes to actually pass a bill.  The hard part has always been getting 60 senators to agree to hold a vote, and reconciliation addresses that.

What's going on, then, is that the Senate cannot pass another healthcare bill.  For the process to move forward, everything must be based on the bill the Senate already passed on Christmas Eve.  The House bill is dead.  "Reconciliation" applies only to whatever amendments House Democrats require before they'll agree to pass the Senate bill.  Those changes will need to take the form of budget items, immunizing them against a Republican filibuster. 

The idea is for the House to pass the Senate healthcare bill exactly as written, and then some sort of budget measure amending it.  Senate Democrats would need to commit to passing the "fix" through reconciliation, because the House has no intention of passing the Senate bill without its own changes.  They'll need a guarantee that their additional language will get 51 votes, and obviously this will all have to be agreed upon in advance.

watching the senate make sausage

I've been trying to keep one eye on CSPAN-2, watching the Senate debate healthcare.

One thing I've noticed is that just about every time a Democrat makes a speech, about a week's worth of blogging material runs through my head.  Half-truths, misrepresentations and sob stories, but not a lot of honesty about what this bill would really do to healthcare in America.

It's a lot like what I see right here on the blog: I give a rational argument explaining why policies like the minimum wage don't accomplish what we'd like them to, and then some liberal lists all the injustices the policy is intended to correct, while completely ignoring my argument.  In the end, we're both right about a lot of things, but only one of us is seeing both sides of the issue, looking at what the policy really does for the people it's supposed to help.

The Republicans have done a pretty good job, considering they don't have the votes to stop this.  For one thing, they've stuck together very well.  So far as I can tell, no Republican has cast the deciding vote on any amendment that's made the bill more likely to pass.  And, of course, they've proposed some thought-provoking amendments and raised excellent objections to the bill.

I think it's been made clear that the bill will be making cuts to Medicare.  Not surprisingly, it's been a lot like arguing with a liberal for Republicans to make this point.  First, the Dems insisted that no "guaranteed benefit" would be cut.  But eventually the Republicans got some sort of Democrat acknowledgement that "if you like what you currently have, you can't necessarily keep it," because whether those benefits are guaranteed or not, Medicare Advantage will be gutted.

Medicare recipients are a big voting bloc, but I think we're past the point where Democrats actually care that the public doesn't like the bill.  This is socialtopia, and they're going to pass it.

Republicans have been hammering on the corruption in the bill, as well.  They've pointed out the back-room deals, the vote-buying and the arm-twisting.  Although "no guaranteed benefit" has been cut, for some reason four Democrat Senators' states have been targeted to receive money to make up for the Medicare Advantage cuts.  Since these cuts are supposed to eliminate waste and overspending, I guess waste and overspending are important in those states.

It's a tough format for finding truth.  It took days for Republicans to force a Democrat admission that you won't necessarily be able to keep coverage that you like.  It's a chess game. 

on voting "present"

This is what I've been talking about.  Associated Press: Senate moderates looking to sweeten the healthcare bill.

Opposing GOP Senators must not allow themselves to be used as the votes that put these amendments over the top.  The greatest resistance to these changes are the liberals who want to pass the overall bill -- let them try and fix it on their own.

The article observes that Ben Nelson will have a difficult time getting a satisfactory abortion amendment.  Presumably that includes GOP votes in favor of the amendment, in a principled stand against abortion.  But we need to end such presumptions.

Nothing good is served by helping give this bill the finishing touches it needs to overcome a filibuster.  There are enough moderate Democrats to help the Republicans make fiscal changes to the bill that would satisfy Joe Lieberman, Mary Landrieu, or even Susan Collins.  But without the Republicans the Democrats would have to dig deep into liberal territory to find the votes to come up with those same fixes.

Now is not the time to worry about the contents of the bill.  No matter what, you can be sure that abortion, the public option, a mandate and Medicare cuts are all going back into the bill in conference.  The goal is to keep the bill from getting there.

It's too liberal to pass.  Leave it that way.

step 1: point gun at foot

RedState analysis: Senate Republicans helping to improve healthcare bill for passage.

I warned about this.  It would be very, very hard for Dems to make substantive improvements to the bill without help from Republicans.  It can't pass the way it is, making the best opposition strategy the one which offers the least help in fixing it.

The GOP is on the brink of helping to make the bill just-good-enough for the last Democrat hold-outs to pass it on a party-line vote.  Bad idea.  What are they thinking?

is it time to vote "present"?

As I understand it, the ideological problem with the healthcare bill currently before the Senate is that it's "too liberal" for about five Democrats, including Olympia Snowe.  It's costly, it subsidizes abortions, and it includes a public option.

Now, the liberals' goal is to sweeten the overall bill, by amending it, just enough to get those Dems onboard.  That's not many votes to add to the bill, but it will take 51 votes to pass each amendment.  So the question is where those votes are going to come from. 

Who will provide the 51 votes necessary to satisfy Joe Lieberman, who says he will not vote for a public option in any form?  Who will provide the 51 votes to limit abortion funding to the satisfaction of Ben Nelson?  I don't think the Republicans should be helping the Dems get this bill over those hurdles.

It can be argued that, in the House, principled conservative votes in favor of the Stupak Amendment resulted in a bill that satisfied enough Democrats to pass a bill Republicans overwhelmingly opposed.  And that's debatable, since at least one Dem -- Stupak -- reportedly would have voted for the bill in exchange for just getting the amendment to the floor.  And, had House Republicans voted "present" on Stupak, it's possible that Nancy Pelosi could have rallied enough Dems willing to pass Stupak as simply part of the price of passing the entire bill.

Let's see how this could work in the Senate.  There are 100 Senators, ranging from liberal to conservative.  Obviously the most conservative are Republicans, while the most liberal are Democrats.

Suppose Ben Nelson introduces an amendment to limit abortion funding.  If, say, 36 of the 40 Republicans supported it on principle, plus the 5 Democrat holdouts, then of the 55 remaining Democrats only 10 would have to sign on for the amendment to pass. 45 liberals get to protect their "pro-choice" visages, while principled Republicans move the bill one Democrat closer to getting passed.  Sound familiar?

it's the public option, stupid.

I can't believe I'm hearing analysis of which Senate Democrats will support a healthcare bill with or without abortion funding.

I think the House made it clear that the entire abortion issue is a smokescreen.  The magician's got you so caught up in his patter that you're completely overlooking the rabbit fidgeting up his sleeve.

what passes for reason

Consider:

A driver's only option is to buy a separate insurance policy that covers accidents, a ridiculous and unworkable approach since no driver plans to have an accident.

I don't know -- does that really sound either ridiculous or unworkable to you?  I mean, I don't plan to have accidents, but as a responsible driver I realize that accidents happen, and I buy insurance because I do plan on driving.  If I only bought insurance because I planned to have accidents, would that really be insurance???

This actual quote was from Congresswoman Jan Schakowsky, D-IL, opposing the Stupak Amendment:

Her only option is to buy a separate insurance policy that covers an abortion, a ridiculous and unworkable approach since no woman plans an unplanned pregnancy.

"No woman plans an unplanned pregnancy."  Monty Python wants to control your healthcare.  Hell, they already have too much control over it; now they're just arguing over how badly they're going to screw it up.

And given Schakowsky's grasp of insurance, there would appear to be no limit.

the principles of holdouts

Let's play a game and pretend, for a few painful minutes, that Democrats are both truthful and accurate in everything they say about healthcare.  Let's think like a liberal.  Like I said, we're pretending.

Suppose millions of people had no access to care, that most bankruptcies were caused by medical debt, that America's healthcare quality was only about the same as Cuba's, and that tens of thousands of people were dying needlessly each year because they lack insurance.  And suppose it's really the practice of doctors to remove organs and limbs when they're having a slow month, that frivolous malpractice lawsuits really don't affect healthcare costs, and that the true value of everything medical is whatever Medicare says it is.

Now suppose you're a liberal Democrat in the House of Representatives.  Before you, there's a bill that you know will insure everyone, lower costs, and raise quality.  The bill is certain to lower infant mortality, increase longevity, raise cancer survivor rates, and make healthcare worries a thing of the past.

There are just two problems: The bill does nothing for illegal aliens, and it does not pay for abortions.  In fact, these aren't really "problems" with the bill so much as they're issues the bill simply doesn't address.  Illegals aren't getting free care now, and the government already doesn't pay for abortions.  These would be two features of the healthcare landscape that the bill simply doesn't change.

Supposing that everything above was true, and considering the breakthrough such a bill would represent after the struggle Democrats have endured to get it to the House floor, wouldn't you be pretty much duty-bound to vote for the bill?  I mean, this would be the Holy Grail of liberal legislation -- it's not like you're going to reject it just because it doesn't provide for some particular special interest, are you?

it's not euthanasia, but...

...it's still close enough to worry this liberal.  Limbaugh discussed Lee Siegel's intriguing piece yesterday, and I had to look it up.  If you've got a conscience, this end-of-life (or, as Rush calls it, end-of-care) nonsense should make you uncomfortable.  Nauseous, even.

...on one point the plan’s critics are absolutely correct. One of the key ideas under consideration—which can be read as expressing sympathy for limitations on end-of-life care—is morally revolting.

Consider this, which Siegel has absolutely nailed:

As for the argument that fruitless tests and “senseless” procedures are bankrupting the health-care system, that is an insult to the intelligence. No one knows which tests and procedures will be effective beforehand. No amount of “study” and research is going to address the particular case and the particular condition, let alone the particular, desperate, irrational will to live—which, in animal terms, is pragmatic and rational.

Siegel, of course, has figured out where the rationing is in Obama's plan.  As I've explained here, it's all about declaring statistically ineffective (but medically justifiable) treatment "wasteful," and reallocating that care to more "effective" uses.